The trajectory of depression and anxiety among children and adolescents over two years of the COVID-19 pandemic

Daphne J Korczak; Ronda F Lo; Jala Rizeq; Jennifer Crosbie; Alice Charach; Evdokia Anagnostou; Catherine S Birken; Suneeta Monga; Elizabeth Kelley; Rob Nicolson; Paul D Arnold; Jonathon L Maguire; Russell J Schachar; Stelios Georgiades; Christie L Burton; Katherine Tombeau Cost

doi:10.1016/j.psychres.2024.116101

The trajectory of depression and anxiety among children and adolescents over two years of the COVID-19 pandemic

Psychiatry Res. 2024 Sep:339:116101. doi: 10.1016/j.psychres.2024.116101. Epub 2024 Jul 23.

Authors

Daphne J Korczak¹, Ronda F Lo², Jala Rizeq², Jennifer Crosbie³, Alice Charach³, Evdokia Anagnostou⁴, Catherine S Birken⁵, Suneeta Monga³, Elizabeth Kelley⁶, Rob Nicolson⁷, Paul D Arnold⁸, Jonathon L Maguire⁹, Russell J Schachar³, Stelios Georgiades¹⁰, Christie L Burton², Katherine Tombeau Cost²

Affiliations

¹ School of Health and Wellbeing, University of Glasgow, Department of Psychiatry, Hospital for Sick Children, Glasgow, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: daphne.korczak@sickkids.ca.
² School of Health and Wellbeing, University of Glasgow, Department of Psychiatry, Hospital for Sick Children, Glasgow, ON, Canada.
³ School of Health and Wellbeing, University of Glasgow, Department of Psychiatry, Hospital for Sick Children, Glasgow, ON, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
⁴ Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
⁵ Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Division of Paediatric Medicine, Hospital for Sick Children, Toronto, ON, Canada.
⁶ Departments of Psychology, Queen's University, Kingston, ON, Canada; Department of Psychiatry, Queen's University, Kingston, ON, Canada.
⁷ Department of Psychiatry, Western University, London, ON, Canada.
⁸ Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, AB, Canada; Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
⁹ Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
¹⁰ Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

PMID: 39068897
DOI: 10.1016/j.psychres.2024.116101

Abstract

Longitudinal research examining children's mental health (MH) over the course of the COVID-19 pandemic is scarce. We examined trajectories of depression and anxiety over two pandemic years among children with and without MH disorders. Parents and children 2-18 years completed surveys at seven timepoints (April 2020 to June 2022). Parents completed validated measures of depression and anxiety for children 8-18 years, and validated measures of emotional/behavioural symptoms for children 2-7 years old; children ≥10 years completed validated measures of depression and anxiety. Latent growth curve analysis determined depression and anxiety trajectories, accounting for demographics, child and parent MH. Data were available on 1315 unique children (1259 parent-reports; 550 child-reports). Trajectories were stable across the study period, however individual variation in trajectories was statistically significant. Of included covariates, only initial symptom level predicted symptom trajectories. Among participants with pre-COVID data, a significant increase in depression symptoms relative to pre-pandemic levels was observed; children and adolescents experienced elevated and sustained levels of depression and anxiety during the two-year period. Findings have direct policy implications in the prioritization and of maintenance of educational, recreational, and social activities with added MH supports in the face of future events.

Keywords: Anxiety; COVID-19; Child and adolescent psychiatry; Depression; Longitudinal data; Neurodevelopmental disorders.

MeSH terms

Adolescent
Anxiety* / epidemiology
Anxiety* / psychology
COVID-19* / epidemiology
COVID-19* / psychology
Child
Child, Preschool
Depression* / epidemiology
Depression* / psychology
Female
Humans
Longitudinal Studies
Male
SARS-CoV-2